The Committee adopted minutes for 12 November 2013, 19 and 16 February and 5 March 2014. The Committee also adopted its North West oversight report and Mpumalanga oversight report.
Members took turns to comment on the Legacy Report, and the Chairperson had a response for each Member's comment. The main, recurring issues were the lack of oversight, the lack of returning to areas the Committee had visited, the quality of health services and the lack of private sector oversight. Within these main issues, there was emphasis on the National Health System the Committee had been working on implementing, and primary health care. The Committee was satisfied with compiling a Legacy Report, as it had not received one from the previous Committee, and felt that it would have done much better if it had had one when it began five years ago.
Adoption of Minutes:
The Chairperson opened the meeting by greeting everyone in attendance, and proceeded to the consideration of Committee minutes.
The Committee adopted the minutes for its meetings on 12 November 2013, 19 February 2014, 26 February 2014, and 5 March 2014.
Adoption of oversight reports:
The Committee considered the North West oversight report.
Ms M Segale-Diswai (ANC) wanted a page designated for acronym explanations.
The Committee adopted the North West oversight report.
The Committee considered the Mpumalanga oversight report.
The Chairperson said that the Committee should promise those in Mpumalanga that they would come again soon.
Ms B Ngcobo (ANC) responded that the Committee had said it would return only if time permitted.
The Chairperson agreed, and withdrew his proposal.
Ms M Dube (ANC) asked the secretary to keep the font consistent and uniform for all the documents, as a different font was apparently used for this report.
The Chairperson said that the secretary would do that.
The Committee adopted the Mpumalanga oversight report.
Ms Ngcobo said that there were two provinces which had not been addressed -- North West and KwaZulu-Natal. She then said that she would like the minutes ready sooner, rather than later.
The Chairperson mentioned the lunch the Committee would be attending the following day.
Ms Segale-Diswai asked if every Member would be allowed to make their own closing statements at this lunch, in addition to each party giving its statement.
The Chairperson stated that it would not be a problem, if time permitted.
Ms Ngcobo stated that she would be happy with only two people speaking.
The Chairperson reassured her that only those who wished to speak would speak.
Adoption of the Legacy Report:
The Chairperson said that he would start the discussion with his comments. The Committee needed to ensure that taxpayers were getting what they needed. However, determining what was needed was difficult, due to the diverse citizenry, and some departments were not benefiting everyone. One of government’s policies was to have universal health coverage, and the Committee had to see that everyone received health care. He was disappointed that after 20 years of democracy not everyone had health cover. Now it would be available, with the National Healthcare System (NHS), although it was still in the piloting stage. The incoming committee needed to know what must happen. He then gave his thanks to the Committee.
Ms T Kenye (ANC) was concerned about the budget and the Department’s affiliated entities, wanting to ensure that they would be managed better. She said that oversight was not to her satisfaction – like ensuring people worked hard and addressed matters such as medical hazards in medical buildings.
The Chairperson stated that praise should be given to those who did a great job, because “human resources” were not always available.
Ms Ngcobo stated that it was important for members of the incoming committee to remain on the committee for the whole term, and not just for a few years before leaving for another committee. There was a need for context and explanations regarding who the Committee sees, or who is presenting to the Committee, such as the political significance of a presentation. This would also include oversight visits. Following up with provinces was vital and following the budget was important. Budgetary items must be checked on a quarterly basis to keep the Committee accountable. Following or not following the budget came down to honesty. She said there were questions about health that should have been addressed that were not – but she did not explain what those questions were or could be.
The Chairperson responded that some of the concerns Ms Ngcobo had addressed were in the report. There had to be a balance between Members' wishes and thinking and the organization, whether it was the Committee or another government entity. The independence of the Members was vital for a successful organization.
Ms Dube stated that labour issues within the Department of Health needed to be included in the oversight visits and reports.
The Chairperson responded that the Department had dealt with the labour issues and people responsible for them, so that was why the Committee had never met with them. There was a woman -- neither he nor any of the Members knew who she was -- who was from the Department and may have dealt with labour, but they did not know what she actually did because she never spoke whenever she attended Committee meetings.
Ms Segale-Diswai thanked the opposition parties for their presence, and said they were smart. Communication was vital towards resolving issues. If there was more communication, she would have known her status in the Committee when she arrived, as she had thought she was an alternative Member. The incoming committee needed to emphasise primary health care. The idea was great, but implementation was not. There was no uniformity across the provinces regarding primary health care. The incoming committee must address the issues with the Departments of Public Works and Transport.
The Chairperson responded that local government and provinces had certain powers which provided obstacles to achieving uniformity of primary health care. The incoming committee must work with local governments. He had projects that were on his desk, along with projects that he knew nothing about, being implemented and this was a cause of inconsistencies. These problems caused people to go to other provinces for health care. There was a communication issue with rural areas as well.
Ms R Motsepe (ANC) wished the Committee could have returned to certain areas, and said that not doing so was a problem. The public attitude towards deficiencies at primary clinics was to come to Parliament and expect problems to be fixed. The problem was serious, as people filled queues and waiting a long time for prescriptions, so they went to the bigger cities expecting better treatment, but ended up not receiving any better service.
The Chairperson responded that people did not know the difference between the Minister and Parliament. The Minister could build clinics where they were needed. The Minister should attend visits with the Committee.
Ms S Kopane (DA) said she had joined the Committee late. She was sad that people did not know that those in Parliament were friends outside party lines. Oversight of entities had not been taken seriously and people were not being held accountable. There was a need to oversee finances. South Africans saw private health care as a threat, but from the outside South Africa it was viewed as the best. Private health care had to be looked at as an asset, not a threat. There was good health care quality, and a lot of money was put into it, yet somehow the quality decreased. She said that assessments did not happen and many workers did nothing.
The Chairperson agreed. This Committee had not received a Legacy Report from the previous committee in 2009. He stressed the need for patriotism and the need to detach from party politics. He explained at length how people who interacted and conversed with each other were more likely to cooperate and not talk badly about each other because they knew each other. This interaction would expose any ulterior motives.
Ms Kenye said that some, but not all, would consider the Committee's recommendations and content in the Legacy Report and that some of the Members would return. The NHS issues were primarily about sustainability. There was a need to compare South Africa to both Britain's and Thailand's health care systems, especially in regard to universal coverage. Research should be done before oversight visits occurred.
The Chairperson responded that Ms Kenye had a different definition of primary health care and NHS. He asked what she meant by “universal coverage”. The systems and circumstances in Britain and Thailand were totally different, as Thailand was totally private and Britain's was run entirely by professionals. He then told a story about a person in the Eastern Cape who was going around filing complaints and winning legal settlements to make money, and robbing the hospitals and clinics.
Ms Dube got the Committee back on track, stating that it needed to address the content of the past five years, to ensure it was included in the report. She stressed the need for private sector oversight and that the incoming Committee and Minister needed to have oversight over both the public and private sector. She admitted that she was unsure about how the oversight of hospitals would happen. She really wanted the Committee's recommendations to be taken seriously.
The Chairperson said that the Committee had the power to summon any relevant entity to report to it. The problem was that the Department issued licenses.
Mr D Kganare (ANC) apologized for not being able to attend the lunch the following day, and thanked the support staff for their efforts. He said that if the Minister were to take responsibility, it would make the Committee more effective. There was a need to be sensitive to unions. If the Committee had received a Legacy Report originally, it would have done much better. If this had happened, he would have wanted the report circulated to all the Members, not just given to the Chairperson. Whether they read it or not was their business.
The Committee adopted the Legacy Report.
The meeting was adjourned.
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